Unknown Individual – Psychiatry Physician, NPI 1356416440
Psychiatry Physician
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Provider Addresses for Unknown Individual
1100, Beech Street, Normal, McLean County, Illinois, 61761, United States
#10 NORMANDY VILLAGE
NORMAL, IL 617611493
Phone: (309) 454-2112
Fax: (309) 452-1265
Type: Location
1206, Stephens Drive, Maplewood Heights, Normal, McLean County, Illinois, 61761, United States
NORMAL, IL 617613955
Phone: (309) 452-3263
Type: Mailing
NPPES updates history
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61761)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | IL | 90792 | Psychiatric diagnostic evaluation with medical services | 146 | 142 |
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